I-tachycardia ye-atrial eminingi

I-Multifocal atrial tachycardia (MAT) isilinganiso esisheshayo senhliziyo. Kwenzeka lapho amasiginali amaningi kakhulu (amandla kagesi) athunyelwa esuka enhliziyweni engenhla (atria) eya enhliziyweni engezansi (ama-ventricles).

Inhliziyo yomuntu ikhipha imizwa kagesi, noma amasiginali, ayitshela ukuthi ishaye. Imvamisa, la masiginali aqala endaweni yegumbi eliphezulu kwesokudla elibizwa nge-sinoatrial node (sinus node noma SA node). Le node ibhekwa njenge- "pacemaker yemvelo" yenhliziyo. Kuyasiza ukulawula ukushaya kwenhliziyo. Lapho inhliziyo ithola isignali, iyavumelana (noma ishaye).

Ukushaya kwenhliziyo okuvamile kubantu abadala kungaba ukushaya okungu-60 kuye kwayi-100 ngomzuzu. Ukushaya kwenhliziyo okuvamile kuyashesha ezinganeni.

Ku-MAT, izindawo eziningi kwizimpawu zomlilo ze-atria ngasikhathi sinye. Izimpawu eziningi kakhulu ziholela ekushayeni kwenhliziyo okusheshayo. Imvamisa iba phakathi kwamabhithi ayikhulu kuya kwayi-130 ngomzuzu noma ngaphezulu kubantu abadala. Isilinganiso senhliziyo esisheshayo senza inhliziyo isebenze kanzima futhi ingahambisi kahle igazi. Uma ukushaya kwenhliziyo kushesha kakhulu, kunesikhathi esincane sokuthi igumbi lenhliziyo ligcwale igazi phakathi kokushaya. Ngakho-ke, alikho igazi elanele elifakwa ebuchosheni nasemzimbeni wonke ngokuncipha ngakunye.

IMAT ivame kakhulu kubantu abaneminyaka engama-50 kuya phezulu. Kuvame ukubonakala kubantu abanezimo ezehlisa inani le-oxygen egazini. Lezi zimo zifaka:

• I-pneumonia yebhaktheriya
• Isifo esingapheliyo se-pulmonary disease (COPD)
• Ukwehluleka kwenhliziyo yokubopha
• Umdlavuza wamaphaphu
• Ukwehluleka kwamaphaphu
• I-embolism yamaphaphu

Ungaba sengozini enkulu ye-MAT uma une:

• Isifo senhliziyo
• Isifo sikashukela
• Ngibe nokuhlinzwa emasontweni ayisithupha edlule
• Ukweqisa izidakamizwa ku-theophylline
• I-Sepsis

Lapho izinga lokushaya kwenhliziyo lingaphansi kokushaya okungu-100 ngomzuzu, i-arrhythmia ibizwa ngokuthi "ukuzulazula kwenhliziyo kwe-atrial."

Abanye abantu kungenzeka bangabi nazimpawu. Lapho kuvela izimpawu, zingabandakanya:

• Ukuqina kwesifuba
• Ubumhlophe
• Ukuquleka
• Ukuzwa kokuzwa inhliziyo ishaya ngokungafani noma ngokushesha okukhulu (ukushaya kwenhliziyo)
• Ukuphelelwa umoya
• Ukwehla kwesisindo nokwehluleka ukuchuma ezinganeni

Ezinye izimpawu ezingenzeka ngalesi sifo:

• Ukuphefumula kanzima lapho ulele phansi
• Isiyezi

Ukuhlolwa ngokomzimba kukhombisa ukushaya kwenhliziyo okungajwayelekile okungaphezu kokushaya okungu-100 ngomzuzu. Umfutho wegazi ujwayelekile noma uphansi. Kungaba nezimpawu zokusakazeka okungalungile.

Ukuhlolwa kokuthola i-MAT kufaka:

• ECG
• Ucwaningo lwe-Electrophysiologic (EPS)

Abahloli benhliziyo basetshenziselwa ukuqopha ukushaya kwenhliziyo okusheshayo. Lokhu kufaka phakathi:

• Ukuqapha kweHolter kwamahora angama-24
• Amarekhodi ephathekayo aphathekayo, wesikhathi eside akuvumela ukuthi uqale ukurekhoda uma kuvela izimpawu

Uma usesibhedlela, isigqi senhliziyo yakho sizobhekwa amahora angama-24 ngosuku, okungenani ekuqaleni.

Uma unesimo esingaholela ku-MAT, leso simo kufanele silashwe kuqala.

Ukwelashwa kwe-MAT kufaka:

• Ukwenza ngcono amazinga eoksijini egazini
• Ukunikeza i-magnesium noma i-potassium ngomthambo
• Ukumisa imithi, efana ne-theophylline, engakhuphula izinga lokushaya kwenhliziyo
• Ukuthatha imithi ukunciphisa izinga lokushaya kwenhliziyo (uma isilinganiso senhliziyo sishesha kakhulu), njenge-calcium channel blockers (verapamil, diltiazem) noma i-beta-blockers

I-MAT ingalawulwa uma isimo esibangela ukushaya kwenhliziyo okusheshayo siphathwa futhi silawulwa.

Izinkinga zingafaka:

• I-Cardiomyopathy
• Ukwehluleka kwenhliziyo yokubopha
• Isenzo sokumpompa esinciphile senhliziyo

Shayela umhlinzeki wakho wezempilo uma:

• Unenhliziyo esheshayo noma engajwayelekile enezinye izimpawu ze-MAT
• Une-MAT futhi izimpawu zakho ziba zimbi kakhulu, azithuthuki ngokwelashwa, noma uba nezimpawu ezintsha

Ukwehlisa ubungozi bokusungula iMAT, phatha ukuphazamiseka okukubangela zisuka nje.

I-tachycardia yesiyaluyalu se-atotic

• Inhliziyo - isigaba phakathi nendawo
• Inhliziyo - ukubuka kwangaphambili
• Uhlelo lokuqhuba kwenhliziyo

Olgin JE, Zipes DP. Ama-arrhythmias aphezulu. Ku: Zipes DP, Libby P, Bonow RO, Mann DL, Tomaselli GF, Braunwald E, ama-eds. Isifo Senhliziyo SikaBraunwald: Incwadi Yemithi Yezinhliziyo Nemithambo. Umhla ka-11. IPhiladelphia, PA: Elsevier; 2019: isahluko 37.

I-Zimetbaum P. Supraventricular arrhythmias yenhliziyo. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 58.